Concept

Clitoridectomy

Summary
Clitoridectomy or clitorectomy is the surgical removal, reduction, or partial removal of the clitoris. It is rarely used as a therapeutic medical procedure, such as when cancer has developed in or spread to the clitoris. It is often performed on intersex newborns. Commonly, non-medical removal of the clitoris is performed during female genital mutilation (FGM). A clitoridectomy is often done to remove malignancy or necrosis of the clitoris. This is sometimes done along with a radical complete vulvectomy. Surgery may also become necessary due to therapeutic radiation treatments to the pelvic area. Removal of the clitoris may be due to malignancy or trauma. Female infants born with a 46,XX genotype but have genitalia affected by congenital adrenal hyperplasia and are treated surgically with vaginoplasty that often reduces the size of the clitoris without its total removal. The atypical size of the clitoris is due to an endocrine imbalance in utero. Other reasons for the surgery include issues involving a microphallus and those who have Mayer-Rokitansky-Kuster disorder. Treatments on children raise human rights concerns. Clitoridectomy surgical techniques are used to remove an invasive malignancy that extends to the clitoris. Standard surgical procedures are followed in these cases. This includes evaluation and biopsy. Other factors that will affect the technique selected are age, other existing medical conditions, and obesity. Other considerations are the probability of extended hospital care and the development of infection at the surgical site. The surgery proceeds with the use of general anesthesia, and prior to the vulvectomy/clitoridectomy an inguinal lymphadenectomy is first done. The extent of the surgical site extends one to two centimeters beyond the boundaries of malignancy. Superficial lymph nodes may also need to be removed. If the malignancy is present in muscular tissue in the region, it is also removed. In some cases, the surgeon is able to preserve the clitoris though the malignancy may be extensive.
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